Comparison of Diode Laser and Conventional Method in Treatment of Gingival Melanin Hyperpigmentation

Year 2021, Volume: 48 Issue: 3, 95 - 100, 31.12.2021

Revan Birke Koca-ünsal , Gökhan Kasnak , Erhan Firatli

https://doi.org/10.52037/eads.2021.0030

Abstract

ABSTRACT
Purpose: We aim to compare the scalpel and diode laser methods in the treatment of gingival hyperpigmentation in terms of postoperative pain and wound healing.
Materials & Methods: Sixteen systemically healthy individuals requesting treatment for light or moderate gingival hyperpigmentation were enrolled for this study. The individuals were randomly assigned to treatment with the diode laser method or conventional scalpel method. Dummett oral pigmentation index was recorded at baseline. The VAS form was given to the individuals and postoperative pain and wound healing were compared on the postoperative 7th day. Comparisons between the groups were tested using the Mann-Whitney U test and P-value < 0.05 was considered significant.
Results: The scalpel group showed total epithelialization, however, the laser group showed incomplete epithelialization. The scalpel group declared significantly higher pain perception in comparison to the laser group on the first and second days after the surgery (p=0,002 and p=0,038, respectively). No significant differences were found between the groups on the fourth and seventh day regarding pain perception (p>0,05). Also, no significant difference was observed in any comparisons between the pain perceptions of female and male individuals (p>0,05).
Conclusion: Both scalpel and diode laser are obtained successful clinical results in the treatment of gingival hyperpigmentation. Although increased chair-time and impaired wound healing at one-week follow-up, intraoperative homeostasis and relatively less postoperative pain reveal the superiority of diode laser to the scalpel. The choice of the method may vary depending on the available equipment and preference of the patient and the clinician.

Keywords

diode laser, gingival hyperpigmentation, postoperative pain, scalpel, vas

References

• Referans1 Cicek Y, Ertas U. The normal and pathological pigmentation of oral mucous membrane: a review. J Contemp Dent Pract. 2003;4(3):76-86.
• Referans2 Lenane P, Powell FC. Oral pigmentation. J Eur Acad Dermatol Venereol. 2000;14(6):448-65.
• Referans3 Sarswathi TR, Kumar SN, Kavitha KM. Oral melanin pigmentation in smoked and smokeless tobacco users in India. Clinico-pathological study. Indian J Dent Res. 2003;14(2):101-6.
• Referans4 Hedin CA, Axell T. Oral melanin pigmentation in 467 Thai and Malaysian people with special emphasis on smoker's melanosis. J Oral Pathol Med. 1991;20(1):8-12.
• Referans5 Alhabashneh R, Darawi O, Khader YS, Ashour L. Gingival depigmentation using Er:YAG laser and scalpel technique: A six-month prospective clinical study. Quintessence Int. 2018;49(2):113-22.
• Referans6 Namdeoraoji Bahadure R, Singh P, Jain E, Khurana H, Badole G. Management of pigmented gingiva in child patient: a new era to the pediatric dentistry. Int J Clin Pediatr Dent. 2013;6(3):197-200.
• Referans7 Tal H, Landsberg J, Kozlovsky A. Cryosurgical depigmentation of the gingiva. A case report. J Clin Periodontol. 1987;14(10):614-7.
• Referans8 Rahmati S, Darijani M, Nourelahi M. Comparison of surgical blade and cryosurgery with liquid nitrogen techniques in treatment of physiologic gingival pigmentation: short term results. J Dent (Shiraz). 2014;15(4):161-6.
• Referans9 Chandna S, Kedige SD. Evaluation of pain on use of electrosurgery and diode lasers in the management of gingival hyperpigmentation: A comparative study. J Indian Soc Periodontol. 2015;19(1):49-55.
• Referans10 Hirschfeld I, Hirschfeld L. Oral pigmentation and a method of removing it. Oral Surg Oral Med Oral Pathol. 1951;4(8):1012-6.
• Referans11 Murthy MB, Kaur J, Das R. Treatment of gingival hyperpigmentation with rotary abrasive, scalpel, and laser techniques: A case series. J Indian Soc Periodontol. 2012;16(4):614-9.
• Referans12 Bakhshi M, Rahmani S, Rahmani A. Lasers in esthetic treatment of gingival melanin hyperpigmentation: a review article. Lasers Med Sci. 2015;30(8):2195-203.
• Referans13 Atsawasuwan P, Greethong K, Nimmanon V. Treatment of gingival hyperpigmentation for esthetic purposes by Nd:YAG laser: report of 4 cases. J Periodontol. 2000;71(2):315-21.
• Referans14 Dummett CO, Barens G. Oromucosal pigmentation: an updated literary review. J Periodontol. 1971;42(11):726-36.
• Referans15 Silness J. and Loe H. Periodontal Disease in Pregnancy. II. Correlation between Oral Hygiene and Periodontal Condtion." Acta Odontol Scand. 1964;22:121-135.
• Referans16 Loe H. and Silness J. Periodontal Disease in Pregnancy. I. Prevalence and Severity. Acta Odontol Scand. 1963;21: 533-551.
• Referans17 Kauzman A, Pavone M, Blanas N, Bradley G. Pigmented lesions of the oral cavity: review, differential diagnosis, and case presentations. J Can Dent Assoc. 2004;70(10):682-3.
• Referans18 Koca RB, Unsal G, Soluk Tekkesin M, Kasnak G, Orhan K, Ozcan I, et al. A review with an additional case: amelanotic malignant melanoma at mandibular gingiva. Int Cancer Conf J. 2020;9(4):175-81.
• Referans19 Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13(4):227-36.
• Referans20 Amaral MB, de Avila JM, Abreu MH, Mesquita RA. Diode laser surgery versus scalpel surgery in the treatment of fibrous hyperplasia: a randomized clinical trial. Int J Oral Maxillofac Surg. 2015;44(11):1383-9.
• Referans21 Jin JY, Lee SH, Yoon HJ. A comparative study of wound healing following incision with a scalpel, diode laser or Er,Cr:YSGG laser in guinea pig oral mucosa: A histological and immunohistochemical analysis. Acta Odontol Scand. 2010;68(4):232-8.
• Referans22 Ortega-Concepcion D, Cano-Duran JA, Pena-Cardelles JF, Paredes-Rodriguez VM, Gonzalez-Serrano J, Lopez-Quiles J. The application of diode laser in the treatment of oral soft tissues lesions. A literature review. J Clin Exp Dent. 2017;9(7):e925-e8.
• Referans23 Ize-Iyamu IN, Saheeb BD, Edetanlen BE. Comparing the 810nm diode laser with conventional surgery in orthodontic soft tissue procedures. Ghana Med J. 2013;47(3):107-11.
• Referans24 Gupta G. Management of gingival hyperpigmentation by semiconductor diode laser. J Cutan Aesthet Surg. 2011;4(3):208-10.
• Referans25 Suragimath G, Lohana MH, Varma S. A Split Mouth Randomized Clinical Comparative Study to Evaluate the Efficacy of Gingival Depigmentation Procedure Using Conventional Scalpel Technique or Diode Laser. J Lasers Med Sci. 2016;7(4):227-32.
• Referans26 Muruppel AM, Pai BSJ, Bhat S, Parker S, Lynch E. Laser-Assisted Depigmentation-An Introspection of the Science, Techniques, and Perceptions. Dent J (Basel). 2020;8(3).
• Referans27 Unsal E, Paksoy C, Soykan E, Elhan AH, Sahin M. Oral melanin pigmentation related to smoking in a Turkish population. Community Dent Oral Epidemiol. 2001;29(4):272-7.